Guess who's back

Hi Guys!

I just wanted to let everyone know that I arrived back in the US safe & sound. My flights went without a hitch and my luggage actually made it all the way to Detroit in one piece!

I just want to send a final shout-out to my Real World Malawi 8:

Shant: A big thank you! I think all of us would agree that you were the glue that held our group together. You are one-of-a-kind and we were lucky to have you with us. Thank you for all of the delicious meals. You are a truly gifted cook.

Tom: Blue tooth box. "hey Tom...you awake...?" Thank you for making me laugh. You are hilarious and...pretty much good at everything! Thank you for starting the flip-cup-Malawi-Chapter, and thank you for introducing me to "Lucy, the Daughter of the Devil".

Kim: Our technical support. Thank you for agreeing to compile all of the pictures. Sorry I took so many. I cannot wait to get the DVD! I hope you are enjoying a large pot of coffee right now!

Emily: Our Chichewa translator. I admire your dedication to learning the language. Thank you for the deep talks, and for being "pretty much a big deal" with me :). Good luck on the rest of your travels and be safe.

Angela: Thank you for being such an awesome roommate. Thank for the girl talk and for understanding me. I don't know what I would have done without you on this trip. You are beautiful and I feel so lucky to have gotten to know you better on this trip.

Katie: Thank for for taking the hits for all of us, and for being such a good sport about it. You made our trip so much fun. You and I will go horseback riding with Angela (and without the boys) when you get back. And I am counting on you to keep me in line next year!

Sammie: "Go Big Or Go Home". I cannot tell you how glad I am that we have become friends. I would trust you with my life. I hope you know that you are going to be an amazing doctor. Thank you for keeping it real.

Everyone: Thank you for making this trip something that I will cherish forever. Thank you for tolerating my loud laugh...well, tolerating me being loud in general. Thank you for putting up with my mothering tendencies, and for helping me keep the "your mom" jokes alive! See you all at graduation!

Zicomo!

Niamh


All of us with Terrie:

Block II -- 8 2009

Block II - 8...I think that Shant came up with the name, and I like it. We were the second group of students in 2009 and there are 8 of us.

Here is our last picture together in Terrie's house as Block II - 8 :




Well, this morning is my last morning here on 24 Kufa Road, and I really cannot believe that the 6 weeks are over. Sorry for the lack of posts all week; I've been busy trying to soak up my last few days in Malawi and I just couldn't justify spending time sitting in front of the computer. The past 6 weeks seem to have flown by, and I am experiencing a wide range of emotions this morning. I had no idea what to expect on this trip, and looking back I know that I could never have imagined that this trip would be as amazing as it was. I loved my time here. I did not save any lives or cure AIDS, but I don't think that was what I was supposed to do here. Instead, I learned more about who I am and what I want to do with my life. I learned about 7 other individuals, that I did not know very well before this trip, but who I now really admire. I learned about people like Terrie, people that are so dedicated to life and medical research, people that I hope I can one day be half as motivated and hard working as. I learned about Malawians, sweet, honest, hard working Malawians. And I learned about people and a culture that are so different from what I am used to. People that get by on so little, and that taught me how I don't need so much. Over the past 6 weeks, both at the hospital and here at our home, I have witnessed joy and despair, hope and fear, laughter and misery, poverty and abundance. I miss my family and friends back in the US and around the world, and I am ready to get back to my old life, but I am not necessarily ready to leave. We have it so nice here, it is almost like we are living in a make-believe world. As students in a foreign country we have no real responsibilities, we can technically do as much or as little work in the hospital as we want, we live in a house where pretty much everything we need is at our fingertips and we get to enjoy the hot sun and beautiful scenery of Malawi. Who wouldn't love it here? It has been a true learning experience and a vacation all in one. It almost feels unfair that I got to round out my medical school career here and not everyone in my class got the same experience. I am ready to get back to having responsibility, and not feeling guilty for living such a comfortable life, but I know that I have to come back here someday.


Thank you all for reading this blog. It has been so much fun writing.

7 of us with Simoni:





Love you all!

Last week in Africa

Last night we enjoyed a delicious dinner prepared by none other than our resident chef, Shant. We then sat around looking at pictures and laughing about past memories.

Thursday night we went out to dinner with Fatima. We went to a really nice Indian restaurant and all got dishes to share. It was sad to say goodbye to her; we love her...and she basically wants to adopt us as her own...so we will miss her! I am sure we will stay in touch.

Tuesday night was so much fun. Like I said before, it was Angela's last night, so Simoni made pizza and salad and Shant, Katherine, Sammie & Katie made tortilla chips and guacamole and Shant made no-bake cookies...so we had a feast! Ang and I tried to help make the chips, but I think we spent more time taking pictures with our aprons on than actually helping. We had 6 of the friends that we have met over here over for dinner, and after dinner we sat around the couch playing guitar (Tom and Angela played), singing and talking. What a nice last night for Ang!

One thing that I forgot to write about thus far is health passports. Every patient has what is called a health passport. It is a little book that looks like an actual passport that has all of the patients health history in it. The poor patients that we see do not have a "primary care doctor" that has all of their medical records. Patients can not just call up their doctor to have their records transferred to the hospital. The idea of the passport is that since most patients live far from the hospital and may travel to many different doctors that will not be able to talk to each other they can just carry their medical records with them. When patients arrive at the hospital the doctor should be able to ask for the passport and from it learn all about the medical history of the patient. When a patient leaves the hospital the doctor writes the discharge summary in the book. The doctor will write the medications that the patient is being sent home on, and the diagnosis of the patient. The problem here is that there is a real stigma attached to a diagnosis of HIV. I never saw a patient fake or edit her/his passport, but the rumor is that patients with a HIV positive diagnosis will change their passport or steal someone else's passport so they are free of the dreaded diagnosis. The whole health passport idea is such an interesting concept. I always wonder if something like it would fly in the US, and while I think it would be cool, I suspect it would not work. Here I really have not seen patients drug seeking or going to the doctor when they are not really sick like I have seen in the US. I wonder if patients in the US would fake problems or change their book for attention. It also seems like not having the passport leaves some of the power of the medical world in the hands of the medical professionals, and keeps the general people at the mercy of the medical professionals. Right now, patients here go to the doctor when they are honestly sick...very sick. I wonder if this country was a little more well off if patients would go to the doctor with simpler problems and then possibly take advantage of their unlimited access to their health history. Just something I have been thinking about...

Well, I have to get going. I will do one more post this week. So sad that my time here is almost up.

Mumbo

We're back from the lake! We got back on Sunday night but we had no internet until yesterday afternoon. Last night we had "family" time and played Cranium so I did not have time to post. Angela leaves tomorrow. We are having her going away party tonight. We are having friends over and Simoni is making pizza (if he can find dough). I am going to miss her so much! She has been on of my roommates this whole trip, and for 2 of the weekends we have shared rooms just the two of us. She is such a good friend and great person. Today I'll go to the hospital, then when I get out I will go to Blantyre with her. The rest of us leave on Saturday. I cannot believe that our time here is almost up! It has been so much fun and such an amazing learning experience!

Well we certainly picked the right trip to take on our last weekend! We had a blast all weekend! Friday started out great when our hired minibus showed up at Terrie's house. It was hot pink. Who can go wrong traveling across Malawi in a pink minibus?

Here is a picture I took of our sweet ride:



We arrived at Gecko Lodge on Friday at about 2pm. The drive took 6 hours and the roads here are not good, so we were all pretty exhausted once we checked into the lodge. Well, it was the perfect place to be exhausted. No one had any plans or expectations for us. We ate lunch, and then read and laid on the beach or in the hammocks until dinner. It was so relaxing. All you could hear was the peaceful sound of the waves crashing against the shore. In the evening was ate dinner and hung out at the bar. There was a party going on at a different lodge. Angela, Kim and Katherine (a girl that we have befriended here) went to the party, while the rest of us crashed early. The 8 of us stayed in one big dorm room that had 8 beds, and 3 fans. Katie and I somehow ended up no where near the fans that night, and we both woke up completely drenched in sweat! The bad thing is that since we know the symptoms associated with various diseases we were both convinced we had Malaria or TB due to the night sweats and feeling feverish! I think we are ok :)

Me, Katie and Kim at Gecko:



The next morning we said goodbye to Katherine and left for Mumbo Island! Angela and Tom kayaked 10 kilometers to the island! Pretty impressive!

Here they are:


The rest of us took the easy route.

Here we are on the boat over to Mumbo:


Even though we did take the easy option for getting to the island, it was not without adventure. The boat ride took 1 hour and half way to the island it started storming. It turns out, the "roof" of that boat doubles as a sieve in the rain! The 5 of us got drenched, and we were so worried about the two in the kayak. Luckily we all made it to the island in one piece.

Our paradise, Mumbo island:





Unfortunately, it did rain all day Saturday & Sunday, but that did not slow us down. We snorkeled, kayaked, read and played games. Shant, Angela and I played speed scrabble while Sammie and Tom became Boa champions (an African game like Mandala). Angela & I were roommates and, in our opinion, we had the best view of the lake from our room.


The 7 of us:


As our pink minibus rode into the sunset on Sunday evening I couldn't help but get nostalgic. The 7 of us bounced around phasing between laughing & joking to daydreaming & sleeping, all strangely content in this foreign country. I am going to miss my 7 roommates so much. I feel so blessed to have been able come on this trip. It is definitely an extra bonus to be here with such an amazing group! I am so lucky.

week 5

Wow! I cannot believe that we are coming to the end of week 5! 7 of us are leaving tomorrow morning for our weekend getaway. Emily is staying here. She will spend Saturday in a local village and then go to church on Sunday. I am a little jealous because I would love to see what church is like here, but I cannot complain, we have a great weekend in store for us. We are going to a place called Cape Maclear tomorrow morning and staying at Gecko Lodge tomorrow night. Supposedly there is a big party going on at Gecko Lodge this weekend with lots of local bands playing. We have been hearing about this party for the past 4 weeks, so it should be fun. On Saturday we are taking a boat across Lake Malawi to Mumbo Island where we will go snorkeling and kayaking! I have never been snorkeling or kayaking so I am sooo excited!

Week 5 was a good week. I spent my week with the girls on OB. One of the most notable things about the patients in general, regardless of if they are on the OB ward or the IM ward, is how passive they are. Doctors do not round everyday so sometimes patients are waiting for days to be evaluated by the doctor. Patients just lay in their bed, very quiet, waiting to be seen. If they need labs or an ultrasound and they cannot get the tests done that day, they wait. There may be nothing really wrong with them anymore and we are just waiting for a repeat chest x-ray to make sure they are ok, but the x-ray machine is broken, so they wait. I have never seen a patient complain, ask questions or demand attention. The patients can be throwing up, writhing in pain or nauseated, but they never complain. If the doctor notices that they are in pain they will ask the nurse to give them pain medication, but if the doctor does not see the patient nothing gets done. What is also amazing is that some of these patients have been sick at home for a long time. One woman is 25 years old and has been short of breath since she gave birth...6 years ago. Now it has gotten to the point that she cannot lay flat without feeling like she cannot breathe so she decided that she needed to go to the hospital. She looks so sad and painful, and she has been waiting all week to be seen by the doctor, but she has never gotten loud, demanding or simply asked for help.
Sammie is on pediatrics and she said that the babies here are also a lot quieter than they are back in the US. In terms of the babies she thinks it is because most of the time their mothers are right by their sides. Anytime a baby cries the mothers start breast feeding them and they stop crying. Women breast feed their babies all the time. On the medicine ward often the women that are sick have small babies with them. Literally, with them. One time a mom was asleep in a bed and her guardian was holding her baby and the baby started crying. The guardian walked over to the mom, reached in to her shirt while she slept and took out her breast and laid the baby next to the mom and attached the baby to the breast. The baby fell asleep and the mom continued to sleep! I was amazed! Often the sick women have small toddlers sleeping in the bed with them. Everywhere I go in the hospital there are women with children on their backs. In general babies are everywhere, and breasts are everywhere! Walking down the street a lady may have a basket on her head, be having a conversation with a friend and have a baby on her breast, all with perfect posture. The women are so calm, and quite resourceful. We have heard from several people that in most families the man is the decision maker and the head of the family. If a woman is counseled about birth control options she has to talk to her husband first before she makes any decision. The problem is that if her husband is not at the hospital with her, then she has to go home to talk to her husband, and if they live several miles from the hospital it may be days, possibly weeks before she makes it back to the hospital, and by then the need for birth control may be obsolete. It is all so different from what we are used to in the US.

I have one more week here, and I still have so much more to learn about the culture! I guess I'll have to come back! :)

Have a good weekend!

sista

Hello All!

Last night was a lot of fun! We looked great in our matching bandannas!

Here is 7 of us. Aren't we cute!?




Here is me and Katie:




Today Katie, Sammie, Kim and I went to a part of the market that sells paintings, jewelry and wood carvings. The artists there are so intense. They all surround you holding their work yelling "sista, sista, look here...look at my painting...sista, please, I have no money please buy my stuff". When you look at someone's work for a minute, and then start to walk away they start to guilt trip you saying "sista why won't you buy my stuff, please sista!" It is so overwhelming. After half an hour my head was spinning, and I had bought way more necklaces than I had intended! They really have a good business strategy!


This week I switched to OB/GYN, and I will spend my last 2 weeks with Emily, Kim and Katie on OB/GYN. I like OB so much that even after one day with the ladies on the ward I am so excited for these next 2 weeks! I am sure I am going to see and learn a lot, but I am sure it is going to be hard. Emily was telling me a story about a woman that came to the hospital that was 7 months pregnant that had been beaten and kicked in the stomach after she wouldn't give robbers 3,000 kwacha (about $21). Sadly the blows to the stomach killed the fetus. Emily said the lady was so sad. I cannot image how hard that must have been.

Well, we are having a guest over for dinner so I should go! Have a good day!

Happy St. Patrick's Day!

Happy St. Patrick's Day! We bought fabric that has a cool green design on it and last night I cut the fabric into bandannas (the only thing all of of us would agree to wear!) and tonight the 8 of us are going to go out to a local bar/restaurant sporting our team bandannas! We are very excited ( and obviously huge nerds!) :) I am sure I'll get some good pictures!

So one thing that I have been meaning to write about is what goes on on the streets here after dark. The only real house rule here is that we cannot walk around outside after dark. There is a restaurant down the street that we can walk to as a group after dark, but that is the only exception, and even then the guard gets nervous when we walk there in the dark. The odd thing is that this is not just Terrie's rule. At the hospital one day one of the locals told me I should not stay too late because it was important that I not be out on the street after dark. When the 6 of came back from the safari and we were waiting for our ride to pick us up from the bus station we had no more minutes left on our cellphone. We asked one of the locals how far it was to the nearest place to top up the phone, and she said oh no, just use my phone, and had her ride wait while we used her phone. Then she left but the guard for the bus station (a man whose job it is to walk around the station all night) told us that he would stay with us until our ride came and that is was really not a good idea for us to walk anywhere in the dark. It seemed extra spooky coming from him seeing that his job means that he is out after dark. It certainly made us all nervous and the 6 of us more or less huddled together under the one spotlight outside the locked, isolated bus station waiting for our ride. What was strange was that the streets around us were abandoned. Not a car or person was in sight, and yet the guard made it crystal clear not to leave. There are no street lights anywhere, so away from the station it would have been pitch black. Scary to think what must go on to make everyone so concerned about the dark. We talked to Terrie last night about her thoughts on why going out at night is so bad, and she said that she is not positive, but one theory is the what she called the "mob mentality". What this means is that during the day there are generally people everywhere so if someone steals something from the market all of the people around will start chasing the thief. She told us that one time she was at work and she saw someone that she didn't know putting a lap top in his bag. She tried to confront him, but he started to run. She was feeling daring at the time so she started chasing the man shouting "thief" in Chichewa. People started joining her and soon she had a whole group of locals were helping her chase down the perpetrator. The man took the laptop out of his bag and threw it in a nearby field. Terrie followed the laptop, and the crowd followed the thief. Later the group caught the man and dragged him back to Terrie shouting "kerosene" in Chichewa! Terrie couldn't believe them! Rather than pour kerosene over him, she compromised with the crowd and called the police and had the man arrested. Terrie said that the prison's are pretty terrible too, so I'm not sure how much of a compromise it was to send him to jail!
I think Terrie is right about the mob mentality idea. I also think there is a good deal of corruption in the legal system so if you were alone and got robbed you would have to pull some strings to get help. I asked a local if there was a short cut home from the market. He said that there was, but he didn't recommend me taking it because it is through an isolated field. He said that he knew a white guy that took the short cut once and got mugged. I think I'll stick to the long route!

Well, I have to head in to the hospital!
Have a good day!